In what could certainly be considered a symbolic victory for President Donald Trump, the second incarnation of the American Healthcare Act (AHCA) squeaked through a vote in the House of Representatives Thursday afternoon. Without a single Democrat vote, the bill was passed 217-213, with twenty Republicans voting against it. Although it may well not get through the Senate in its current form, a rift within the majority party has been bridged and that – in itself – is a victory for congressional Republicans who have seen so very few victories, of late.
The previous attempt to move healthcare legislation through the House stalled when moderate Republicans made clear their intention to withhold support. The party’s conservative wing, the Freedom Caucus, also declined to support the first version of AHCA. Changes made to the bill were not enough to win Freedom Caucus backing. Rather than bend legislation in their direction, the group walked away, creating a potentially damaging schism. This time around, the conservatives accepted key modifications and all but one Freedom Caucus member voted to pass the bill.
Of course, House Republicans may be a little premature in their celebrations; in another fine example of the party continuing to work against itself, Senate Republicans indicate that they are in no rush to take up the bill. Worse still, they plan to put together their own bill which will, likely, cause further dissent in the House. Senator Roy Blunt (R-Mo.), who – according to a report in Red State – is leading a Senate ‘working group’ on healthcare, is more concerned with coming up with the votes needed to pass a bill in the Senate than he is with rushing the process. “The safest thing to say is there will be a Senate bill,” he said, “but it will look at what the House has done and see how much of that we can incorporate in a product that works for us in reconciliation.” Echoing a sentiment expressed by other Senate Republicans, he added, “I can’t imagine there will be a rush to take up the bill as much as a real concentrated effort to find where the 51 votes might be if the 51 votes are still available.”
Whilst it would always seem smarter to get a bill right than get it done quickly, the prospect of an entirely different bill coming out of this working group does not bode well.
The sad reality is that the Democratic Party has pushed Americans in the direction of accepting that healthcare is a right and that government should provide universal coverage. Republicans lack the courage to disabuse voters of these notions. The days when government was not involved in the healthcare business are gone forever, it would appear. The mere mention of Americans “losing their coverage” now sends chills down the spines of almost every politician.
The Freedom Caucus is now the only political faction within the federal government that continues to push for truly private-sector solutions. Theirs is not an enviable task. If they walk away from the negotiating table, once again, when the Senate bill eventually goes back to the House, they will remain on the fringe. Work with their Republican colleagues to fashion a bill able to make it to the president’s desk and they risk being associated with government-run healthcare. That is, perhaps, all they can do, other than publicize their own disclaimer; that Americans will fall into a cycle of paying ever more tax on everything, to fund a bloated healthcare bureaucracy that delivers unsatisfactory results. The Democratic Party is already celebrating victory in 2018, certain that the passage of AHCA will doom Republicans running for re-election in 2018. The Democrats are unlikely to score a victory in the mid-term elections, but they may not need to; the Republicans may defeat themselves.
The immediate fate of the president’s party is now in the hands of Senator Mitch McConnell (R-KY) and his colleagues.
Just like that, the swamp is back.
